Evaluating dental student self-assessment across preclinical anatomy waxing and operative exercises.

PURPOSE/OBJECTIVE: A career in healthcare is built on the foundations of continuous self-reflection and self-assessment. Previous studies have solely compared student self-assessment to faculty grades in a single discipline. The objective of this study was to investigate whether associations of a student's self-assessment skills exist across multiple disciplines in the predoctoral setting. METHODS: Sixty-five students from two class years at the Harvard School of Dental Medicine completed preclinical competency exams in dental anatomy waxing and operative dentistry. The difference between the student's self-assessment score and average faculty grade for each exercise was calculated as the student‒faculty (S-F) gap, which served as a proxy to determine how students evaluate their work. Regression analysis was performed to assess associations between wax-up and preclinical operative S-F gaps. RESULTS: Mean S-F gaps for waxing and preclinical operative procedures were positive (5.7 ± 6.1 and 7.6 ± 6.7, respectively). Additionally, students in the lower quartile tended to overestimate performance to a greater degree than their peers in the upper quartile. Furthermore, the waxing S-F gaps were positively associated with S-F gaps of each operative procedure, particularly with the combined operative exercise S-F gaps, where a statistically significant association was seen (coefficient = 0.28; p = 0.04). CONCLUSION(S): Previously, we identified a negative correlation between students' self-assessment skills (S-F gaps) and their preclinical performance. In this study, we further demonstrated an association of S-F gaps in two fundamental exercises: wax-up and operative dentistry. This underscores the roles of S-F gaps as possible indicators of students' preclinical and clinical performance, and it holds potential to become a widely standardized and applicable calculation that may help evaluate the effectiveness of the dental curricula and optimize student learning.

Evaluation of a workplace assessment method designed to improve self-assessment in operative dentistry: a quasi-experiment.

BACKGROUND: Dental education has placed continued emphasis on self-regulated learning (SRL) and its subprocess, self-assessment. This study set out to evaluate the effectiveness of a novel workplace assessment method in developing trainees' self-assessment of operative procedures. METHODS: A Direct Observation of Procedural Skills (DOPS) form was modified for the use and measurement of self-assessment. Participants were trained on how to conduct self-assessment using the designed assessment form and its grading rubric. Feedback and feedforward sessions were given to address self-assessment and performance issues. A P-value less than 0.10 was considered significant and the confidence level was set at 90%. RESULTS: Thirty-two Year 5 dental students with an age mean of 22.45 (SD = 0.8) completed five self DOPS encounters during the clinical operative dentistry module in 2022. The aggregated total deviation (absolute difference) between self-assessment and teacher assessment decreased consistently in the five assessment encounters with a significant mean difference and a medium effect size (P = 0.064, partial Eta squared = 0.069). Participants' self-assessment accuracy differed from one skill to another and their ability to identify areas of improvement as perceived by teachers improved significantly (P = 0.011, partial Eta squared = 0.099). Participants' attitudes towards the assessment method were positive. CONCLUSIONS: The findings suggest that the self DOPS method was effective in developing participants' ability to self-assess. Future research should explore the effectiveness of this assessment method in a wider range of clinical procedures.

Preclinical dental students self-assessment of an improved operative dentistry virtual reality simulator with haptic feedback.

To test and evaluate the second installment of DENTIFY, a virtual reality haptic simulator for Operative Dentistry (OD), on preclinical dental students, by focusing on user performance and self-assessment. Twenty voluntary unpaid preclinical dental students, with different background experience, were enrolled for this study. After the completion of an informed consent, a demographic questionnaire, and being introduced to the prototype (on the first testing session), three testing sessions followed (S1, S2, S3). Each session involved the following steps: (I) free experimentation; (II) task execution; S3 also included (III) completion of questionnaires associated with the experiment (total of 8 Self-Assessment Questions (SAQ)); and (IV) guided interview. As expected, drill time decreased steadily for all tasks when increasing prototype use, verified by RM ANOVA. Regarding performance metrics (Comparisons by Student's t-test and ANOVA) recorded at S3, in overall, a higher performance was verified for participants with the following characteristics: female, non-gamer, no previous VR experience and with over 2 semesters of previous experience of working on phantom models. The correlation between the participants' performance (drill time), for the four tasks, and user self-assessment evaluation, verified by Spearman's rho analysis, allowed to conclude that a higher performance was observed in students who responded that DENTIFY improved their self perception of manual force applied. Regarding the questionnaires, Spearman's rho analysis showed a positive correlation between the improvement DENTIFY inputs on conventional teaching sensed by students, also enhancing their interest in learning OD, their desire to have more simulator hours and the improvement sensed on manual dexterity. All participating students adhered well to the DENTIFY experimentation. DENTIFY allows for student self-assessment and contributes to improving student performance. Simulators with VR and haptic pens for teaching in OD should be designed as a consistent and gradual teaching strategy, allowing multiplicity of simulated scenarios, bimanual manipulation, and the possibility of real-time feedback to allow for the student's immediate self-assessment. Additionally, they should create performance reports per student to ensure self-perception/criticism of their evolution over longer periods of learning time.

Patients' Management Patterns for Restorative Treatment Procedures: A 4-Year Overview at the Restorative Clinic of a Tertiary Hospital in Nigeria

Abstract Objective: To determine the patients' management pattern for restorative treatment procedures at the Restorative Dentistry Clinic at the Lagos State University Teaching Hospital (LASUTH). Material and Methods: A descriptive and retrospective study design was employed to determine patients' management patterns for the restorative treatment procedures at the Restorative Dentistry Clinic at LASUTH. Treatment records of patients who attended the Restorative Clinic at the Lagos State University Hospital, Ikeja, Lagos, Nigeria, from 2011 to 2014 were reviewed; the effective treatments during the period under review were recorded as treatment procedures and were recorded as operative, endodontic, fixed prosthodontics, and removable procedures. Results: A total of 14,437 (75%) operative; 1,353 (7.0%) endodontic; and 559 (2.9%) fixed prosthodontics and 2,852 (14.9%) removable prosthodontic procedures were carried out during the period under review. This study showed that operative procedures were the most performed restorative procedures, whereas removable prosthodontics and endodontic procedures ranked second and third, respectively, to operative procedures. Fixed prosthodontics procedures were the least performed restorative procedures. Conclusion: This study showed that more efforts were being expended by dentists on operative services compared to endodontic, removable, and fixed prosthodontics services combined. Comprehensive studies, embracing all disciplines of dentistry, should be carried out to determine the level of demand and clinical relevance of procedures in clinical dental practice and hence to set specific and general objectives of dental education for the populace. Access to dental health Insurance services should also be increased in the country.

The effect of gender on student self-assessment skills in operative preclinical dentistry.

PURPOSE/OBJECTIVE: Self-assessment is a fundamental skill for dentists and other health care providers. It enables these professionals' ability to critically evaluate the quality of their clinical work and improve through self-directed learning. Researchers have investigated how gender affects self-assessment skills and have shown that male students tend to overestimate their performance while female students tend to underestimate theirs as compared to peer or faculty assessment. The goal of this study was to evaluate how the self-assessment skills of dental students differ by gender in operative preclinical dentistry. METHODS: Third-year dental students (N = 208, Class of 2016-2021) self-assessed their work using the same rubrics as faculty on four operative dentistry competency examination procedures: Class II amalgam preparation and restoration and Class III resin-composite preparation and restoration. Two calibrated full-time faculty graded all procedures independently. The Student self-assessment-Faculty grade (S-F) gap scores were calculated and statistically analyzed. RESULTS: Overall, both genders overestimated their self-assessment for all four procedures as compared to actual scores given by faculty. Males overestimated more significantly than females for Class II Amalgam preparation, but not for the other three procedures. However, when the S-F gap for all procedures was combined and analyzed together, male students significantly overestimated their self-assessments compared to female students. When female and male students grading scores were stratified into quartiles, there were significantly larger differences between males and females in the lower quartiles, which suggest that difference in self-assessment abilities was more prominent among the lower performing students. CONCLUSION: The results of this study demonstrate that gender may affect the accuracy of self-assessment in operative preclinical dentistry.

Reporting quality of systematic review abstracts in operative dentistry: An assessment using the PRISMA for Abstracts guidelines.

OBJECTIVES: To assess and compare the reporting quality of systematic review (SR) abstracts in operative dentistry published before and after the release of Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Abstracts (PRISMA-A), and to identify factors associated with reporting quality. METHODS: PubMed was searched for abstracts published during 2010-2012 (Pre-PRISMA period) and 2017-2019 (Post-PRISMA period). Reporting quality was assessed and scored using a modified 13-item PRSIMA-A checklist. Risk ratio (RR) was used to compare the adequate reporting rate of each item between the two periods. Univariable and multivariable linear regression analyses were performed to identify factors associated with reporting quality. RESULTS: A total of 160 abstracts were included and assessed. Only four items ('objective', 'results of main outcomes', 'description of the effect' and 'interpretation') were adequately reported in most abstracts (>75 %). According to the multivariable analysis, greater word count (P = 0.001), being published in the Post-PRISMA period (P = 0.025) and geographic origin from Asia (P = 0.025) or South America (P = 0.015) were significantly associated with higher reporting quality. CONCLUSIONS/CLINICAL SIGNIFICANCE: The reporting quality of SR abstracts in operative dentistry had improved significantly after the publication of PRISMA-A, but was still suboptimal. Researchers, reviewers and journal editors in operative dentistry need to be familiar with the PRISMA-A checklist, and make concerted efforts to improve the reporting of SR abstracts.

A Cross-Sectional Analysis of Community Water Fluoridation and Prevalence of Pediatric Dental Surgery Among Medicaid Enrollees.

Importance: Dental surgery under general anesthesia (DGA) is an ineffective, costly treatment for caries. Interventions to reduce the need for DGA are challenging because children's parents may not seek care until surgery is required. Community water fluoridation (CWF) effectively prevents early childhood caries, but its effectiveness in reducing severe early childhood caries is unknown. Objective: To determine whether access to CWF is associated with the prevalence of DGA. Design, Setting, and Participants: This is a cross-sectional analysis of Medicaid claims data from 2011 to 2012. Deidentified data were derived from Medicaid claims and enrollee files for Massachusetts, Texas, Connecticut, Illinois, and Florida for children aged 9 years and younger enrolled in either a fee-for-service or managed care plan through their state's Medicaid program. Linear regression models tested for associations between CWF and covariates. Multivariable linear regression models tested for associations between CWF and outcomes. Regression models included clustered SEs at the county level. Data analysis was performed from December 2018 to March 2020. Exposures: Access to CWF was determined by estimating the proportion of a county's total population that had access to a fluoridated public water system. Main Outcomes and Measures: The main outcome was county-level DGA prevalence. Other outcomes were caries-related visit prevalence and patient quality indicators (asthma and diabetes). Covariates included county-level demographic, socioeconomic, and dental practitioner variables. Results: A total of 436 counties within 5 states per year (872 county-year observations), were included in the analysis. Adjusted analysis revealed that a 10% increase in the proportion of county's population access to CWF was associated with lower caries-related visit prevalence (-0.45 percentage points; 95% CI, -0.59 to -0.31 percentage points; P < .001). Increasing CWF access in 10% increments was associated with decreased DGA prevalence in unadjusted analysis (-0.39 percentage points; 95% CI, -0.67 to -0.12 percentage points; P = .006) but not in adjusted analysis (-0.23 percentage points; 95% CI, -0.49 to 0.02 percentage points; P = .07). Increasing the proportion of county's access to CWF by 10% was not associated with the prevalence of asthma-related exacerbations (-0.02 percentage points; 95% CI, -0.10 to 0.05 percentage points; P = .53) or diabetes-related exacerbations (-0.0003 percentage points; 95% CI, -0.0014 to 0.0009 percentage points; P = .66). Conclusions and Relevance: This study extends our understanding of CWF's benefits for children's oral health. Specifically, these findings suggest that increasing a population's access to CWF's is associated with decreased caries-related visits and may also be associated with use of dental surgical services within high-risk populations.

Students' self-assessment of competencies in the phantom course of operative dentistry.

INTRODUCTION: The aim was to assess the competencies of undergraduate students in their roles of dental expert, scholar, communicator, collaborator, health advocate, manager and professional. MATERIALS AND METHODS: For this retrospective, pseudonymised observational study (pre-/post-testing), students in two cohorts in their first clinical semester in operative dentistry were asked to judge their competencies (1 = very good to 6 = insufficient) with a learning objective catalogue designed at the Goethe University Frankfurt (modelled after the National Competency-Based Learning Objective Catalogue Dentistry), at the beginning and end of their phantom course. In order to relate the students' subjective competency judgements to objective evidence of their skills, at the end of the semester their marks from the summative Objective Structured Practical Examination (OSPE) were compared with the subjective judgement of their exam performance before the final results were known. RESULTS: The reliability of the evaluation sheet was evaluated with Cronbach's alpha 0.98. The students judged their competencies as "sufficient" (4.23 ± 0.51) at the beginning and "satisfactory" (2.82 ± 0.43) at the end. A significant improvement in competencies was observed within all roles. The students' subjective judgement of the exam results (3.66 ± 0.62) was significantly correlated with the actual marks (3.69 ± 0.83) in the OSPE at 0.3547 (P = 0.0015). CONCLUSION: The evaluation instrument showed excellent reliability. The students judged that their competencies significantly increased during the semester. The triangulation with the actual marks in the context of an OSPE demonstrated a significant correlation with the students' exam judgements.

Is it cost-beneficial to society? Measuring the economic worth of dental residency training.

This study estimated whether continued programming of a highly specialized four-year dentistry residency training in Saudi Arabia was cost-beneficial. We utilized a purposive sampling to administer a survey to trainees in major cities. Additionally, we used publically available market information about general practitioners. We employed Benefit-Cost Analysis accounting approach as a conceptual framework. Using general practitioners as the base category, we grouped overall social analytical perspectives into resident trainees and rest of society. The residency program was cost-beneficial to trainees, realizing an estimated return of SR 4.07 per SR 1 invested. The overall societal return was SR 0.98 per SR 1 invested, slightly shy of a bang for the buck, in part because the public sector largely runs the training. Benefits included increased earnings and enhanced restorative dentistry skills accruing to trainees; increased charitable contributions and programming-related payments accruing to programs and the public; and practice-related payments accruing to governmental, professional, and insurance agencies. Rest of society, notably government underwrote much of the cost of programming. A sensitivity analysis revealed the results were robust to uncertainties in the data and estimation. Our findings offer evidence to evaluate whether continued residency training is cost-beneficial to trainees and potentially to overall society.

Student Self-Assessment of Operative Dentistry Experiences: A Time-Dependent Exercise in Self-Directed Learning.

The aim of this study was to evaluate the process of student self-assessment on operative dentistry skills across four years at the University of Louisville School of Dentistry. First, a retrospective analysis of the Class of 2016 students' self-assessment and faculty assessment grade sheets was conducted to determine mean differences and correlations across time. Both preclinical (D2: n=120) and clinical (D3: n=120; D4: n=120) grade sheets were evaluated. Second, 25 students from each of the D1, D2, D3, and D4 classes in 2016 were asked to evaluate dentoform work, and 25 operative calibrated faculty members graded the same two dentoforms. The results of the retrospective analysis were that the D2 students' self-assessment scores were significantly higher than the faculty scores (t-test; p<0.05), and there was a negative correlation of scores (r=-0.503). The D3 students' self-assessment scores were also significantly higher than the faculty scores (t-test; p<0.05), and there was a negative correlation (r=-0.235). The D4 students' self-assessment scores were not significantly different from the faculty scores (t-test; p>0.05), and there was a positive correlation (r=0.408). In the prospective analysis, the D1, D2, and D3 students graded the dentoforms significantly higher (ANOVA; p<0.05) than did the D4 students and faculty members. There was an increasing correlation of scores directly related to experience (D1: r=-0.120; D2: r=0.255; D3: r=0.352; D4: r=0.689). These results support the concept that students' self-assessment is a learned process through experiential and continual encounters across time. The summative goal for all dental schools is to provide students with the skills and knowledge to critically evaluate their work for self-directed learning.

The Relationship Between Dental Students' Assessment Ability and Preclinical and Academic Performance in Operative Dentistry.

Self-assessment is a critical skill for health care professionals. Because these professionals must be lifelong, self-directed learners and self-regulating practitioners, the ability to self-assess is essential for them. The aims of this study were to measure how dental students self-assessed and peer-assessed their performance in preclinical operative procedures and to evaluate any relationship between their assessment ability and preclinical skills or academic performance. The study was conducted from 2015 to 2016. Third-year students at Harvard School of Dental Medicine self-assessed their work on four preclinical practical exams: Class II amalgam preparation, Class II amalgam restoration, Class III composite preparation, and Class III composite restoration. Three faculty members graded the same preparations and restorations. The difference between the students' self-assessment and the mean faculty assessment was calculated as the student-faculty (S-F) gap. An absolute S-F gap was also calculated with absolute values of differences. A total of 71 students completed these practical exams: 36 in the Class of 2016 and 35 in the Class of 2017. All 71 self-assessments for each of the four practical exams were collected for a response rate of 100%. The results showed that the mean S-F gap ranged from 2% to 8%, and the absolute S-F gap ranged from 7% to 12%. Preclinical performance was correlated with self-assessment accuracy. Low-performing students significantly overestimated their self-assessments compared to the rest of the class. High-performing students had more accurate self-assessments and tended to underestimate themselves. Overall, these results showed that the students had room for improving the accuracy of their self-assessments.

Re-interventions after restoring teeth-Mining an insurance database.

OBJECTIVES: The aim of this study was to examine re-interventions after restorative treatment. METHODS: The data was collected from the digital database of a major German national health insurance company. Only permanent teeth were observed. Placing a permanent restoration other than a crown regardless of involved surfaces and material was the study intervention. The data did not allow for a differentiation between fillings and inlays that were estimated only a very small portion of the restorations. Success was defined as not undergoing any restorative re-intervention with fillings or inlays on the same tooth (primary outcome) and assessed with Kaplan-Meier survival analyses over four years. An additional analysis was conducted rating "crowning" and "extraction" of respective teeth as target events. Differences were tested with the Log-Rank-test. A multivariate Cox regression analyses was carried out. RESULTS: A total of 17,024,344 restorations placed in 4,825,408 anterior teeth and 9,973,177 posterior teeth could be traced. Focussing on the primary outcome re-intervention, the cumulative four-year success rate was 69.9% for one surface restorations, 74.8% for two surface restorations, 66.6% for three surface restorations and 61.0% for four surface and more extended restorations. These differences were significant (p<0.0001). Focussing on all three target events re-intervention, crowning and extraction, the cumulative four-year success rate was 66.1% for one surface restorations, 67.5% for two surface restorations, 63.0% for three surface restorations and 55.8% for four surface and more extended restorations. The number of restoration surfaces as well as the tooth position remained significant in the multivariate Cox regression. CONCLUSIONS: The sustainability of restorative dental treatment under the terms and conditions of the German national health insurance system shows room for improvement. From a public health perspective, special focus should be laid on primary and secondary prevention to minimize the restorative treatment need. CLINICAL SIGNIFICANCE STATEMENT: This study shows that re-interventions are observed regularly after restorative treatment. Therefore, preventive and restorative strategies should be revisited and optimised.

Development and Assessment of Discrimination Exercises for Faculty Calibration in Preclinical Operative Dentistry.

The aims of this study were to identify the level of interexaminer agreement among preclinical operative dentistry faculty members when grading Class II preparations performed by first-year dental students; to develop discrimination exercises for specific preparation components where interexaminer agreement was poor; and to evaluate if the discrimination exercises were able to improve inter- and intraexaminer agreement. In the preliminary phase of this study, 13 components of 32 Class II cavity preparations were assessed by eight course faculty members at one U.S. dental school. Analysis of average interexaminer agreement on these components revealed that six were below 60%. These were proximal contact clearance, retention groove placement, retention groove depth, preparation walls, preparation margins, and preparation toilet/debris. A 30-minute calibration session was subsequently developed to provide discrimination exercises utilizing 3-D models and digital images of various levels of student performance for five of the six components. Immediately following calibration, the course faculty assessed the same 32 preparations (Phase I) followed by a delayed assessment without calibration (Phase II) approximately six months later. The results showed that overall interexaminer reliability improved after calibration. Although there was a decline in interexaminer reliability after an interval of six months (Phase II), the degree of variation among examiners was lower than in the preliminary assessment. These findings support the use of discrimination exercises for preclinical operative dentistry course faculty to increase interexaminer agreement and thereby improve the consistency of faculty-student communication.

Dental School Vacant Budgeted Faculty Positions, Academic Years 2011-12 Through 2013-14.

The American Dental Education Association (ADEA) Survey of Dental School Faculty is conducted annually to provide an overview of the hiring and retention activity of U.S. dental school faculty. The survey collects data on the dental faculty workforce, including vacant budgeted positions by appointment and discipline, number of new and lost positions, sources of new hires, and reasons for faculty separations. This report highlights the results of three years of survey data, from the 2011-12 academic year through the 2013-14 academic year. After declining in previous years, the number of vacant faculty positions in U.S. dental schools has begun to increase, rising to 242 full-time and 55 part-time positions in 2013-14. Additionally, the number of schools having more than ten vacancies increased from five to 12. Although the number of vacancies has increased, the length of faculty searches that took more than one year declined from 25% to 16% in the same period. Retirements as a share of full-time faculty separations increased from 14% in 2008-09 to 31% in 2013-14. The current average retirement age of dental school faculty members is 69.7 years. The percentage of full-time faculty members leaving for the private sector remained constant over the last three years at approximately 16%. Full-time faculty members were more likely to be recruited from other dental schools, while part-time faculty members were more likely to come from the private sector.

Preparedness of Entering Pediatric Dentistry Residents: Advanced Pediatric Program Directors' and First-Year Residents' Perspectives.

For children to receive needed oral health care, adequate training at both the predoctoral and postdoctoral levels of dental education is required, but previous studies have found inadequacies in predoctoral education that lead to general dentists' unwillingness to treat certain young populations. As another way of assessing predoctoral preparation, the aim of this study was to determine the perspectives of first-year residents and pediatric program directors about residents' preparedness to enter advanced education programs in pediatric dentistry. Surveys were sent to all 74 U.S. program directors and 360 first-year residents. The survey focused on procedures related to prevention, behavior management, restorative procedures, pulp therapy, sedation, and surgery, as well as treating patients funded by Medicaid and with special health care needs. Among the first-year residents, 173 surveys were returned for a 48% response rate; 61 directors returned surveys for an 82% response rate. Only half of the residents (55%) reported feeling adequately prepared for their first year in residency; less than half cited adequate preparation to place stainless steel crowns (SSCs) (42%) and perform pulpotomies (45%). Far fewer felt adequately prepared to provide treatment for children six months to three years of age, including examinations (29%), infant oral exams (27%), and children with severe caries (37%). The program directors were even less positive about the adequacy of residents' preparation. Only 17% deemed them adequately prepared to place SSCs and 13% to perform pulpotomies. Approximately half reported their first-year residents were inadequately prepared to treat very young children and children with severe caries (55% each). This study found that the perceived inadequacy of predoctoral education in pediatric dentistry was consistent at both the learner and educator levels, supporting previous studies identifying inadequacies in this area.

Wound Healing of the Laterally Positioned Flap: A Histomorphometric Assessment.

The aim of this study was to histomorphometrically assess the soft tissue anatomy in single gingival recessions (GR) treated with a laterally positioned flap (LPF). Five patients presenting maxillary first molars with GR to the apex of the buccal surface of the mesial-buccal root were invited to take part. The LPF-treated roots were removed en bloc (the root and the soft tissue covering the treated GR) 3 to 4 months postoperatively. Photomicrographs of Mallory trichrome stain sections were taken to allow reassessment of the specimens regarding the longitudinal dimensions of the crevicular/sulcular and junctional epithelia. The use of LPF resulted in new attachment with formation of crevicular epithelium, long junctional epithelium, and some connective tissue, re-establishing the normal anatomical characteristics of the soft tissues covering the previously exposed root.

Evaluation of an Innovative Digital Assessment Tool in Dental Anatomy.

AIM: The E4D Compare software is an innovative tool that provides immediate feedback to students' projects and competencies. It should provide consistent scores even when different scanners are used which may have inherent subtle differences in calibration. This study aimed to evaluate potential discrepancies in evaluation using the E4D Compare software based on four different NEVO scanners in dental anatomy projects. Additionally, correlation between digital and visual scores was evaluated. MATERIALS AND METHODS: Thirty-five projects of maxillary left central incisors were evaluated. Among these, thirty wax-ups were performed by four operators and five consisted of standard dentoform teeth. Five scores were obtained for each project: one from an instructor that visually graded the project and from four different NEVO scanners. A faculty involved in teaching the dental anatomy course blindly scored the 35 projects. One operator scanned all projects to four NEVO scanners (D4D Technologies, Richardson, TX, USA). The images were aligned to the gold standard, and tolerance set at 0.3 mm to generate a score. The score reflected percentage match between the project and the gold standard. One-way ANOVA with repeated measures was used to determine whether there was a significant difference in scores among the four NEVO scanners. Paired-sample t-test was used to detect any difference between visual scores and the average scores of the four NEVO scanners. Pearson's correlation test was used to assess the relationship between visual and average scores of NEVO scanners. RESULTS: There was no significant difference in mean scores among four different NEVO scanners [F(3, 102) = 2.27, p = 0.0852 one-way ANOVA with repeated measures]. Moreover, the data provided strong evidence that a significant difference existed between visual and digital scores (p = 0.0217; a paired - sample t-test). Mean visual scores were significantly lower than digital scores (72.4 vs 75.1). Pearson's correlation coefficient of 0.85 indicated a strong correlation between visual and digital scores (p < 0.0001). CONCLUSION: The E4D Compare software provides consistent scores even when different scanners are used and correlates well with visual scores. CLINICAL SIGNIFICANCE: The use of innovative digital assessment tools in dental education is promising with the E4D Compare software correlating well with visual scores and providing consistent scores even when different scanners are used.

Utilizing self-assessment software to evaluate student wax-ups in dental morphology.

Traditionally, evaluating student work in preclinical courses has relied on the judgment of experienced clinicians utilizing visual inspection. However, research has shown significant disagreement between different evaluators (interrater reliability) and between results from the same evaluator at different times (intrarater reliability). This study evaluated a new experimental software (E4D Compare) to compare 66 student-produced tooth wax-ups at one U.S. dental school to an ideal standard after both had been digitally scanned. Using 3D surface-mapping technology, a numerical evaluation was generated by calculating the surface area of the student's work that was within a set range of the ideal. The aims of the study were to compare the reliability of faculty and software grades and to determine the ideal tolerance value for the software. The investigators hypothesized that the software would provide more consistent feedback than visual grading and that a tolerance value could be determined that closely correlated with the faculty grade. The results showed that a tolerance level of 450 µm provided 96% agreement of grades compared with only 53% agreement for faculty. The results suggest that this software could be used by faculty members as a mechanism to evaluate student work and for students to use as a self-assessment tool.

Effect of Employing Different Typodonts When Using E4D Compare for Dental Student Assessment.

The use of computers to aid in instruction and help decrease the subjective component of assessment is steadily increasing. One of the potential barriers to the effective utilization of CAD/CAM technology for assessment purposes is the efficient scanning of the teeth being used for comparison. The purpose of this pilot study was to determine if the use of different typodonts, of the same make and model, has any significant effect on the percent comparison results when using E4D Compare. Tooth #30 was prepared by a faculty member to represent what dental students at Georgia Regents University are taught as the ideal preparation for a full gold crown. Ten typodonts of the same make and model were selected for comparison. Three different examples of students' preparations were scanned and compared to the ideal preparation. Each of the three student preparations was subjected to ten trials (occasions), one for each typodont, at five tolerance levels: 0.1 mm, 0.2 mm, 0.3 mm, 0.4 mm, and 0.5 mm. The intraclass correlation coefficient (ICC) was used to measure the intrarater agreement among the typodonts at the various tolerance levels. The agreement coefficients (0.971-0.984) indicated very little variability attributable to the use of a different typodont. The high agreement coefficients achieved using different typodonts of the same make and model provide evidence for the interchangeability of typodonts when assessing a student's performance in the preclinical simulation environment.